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British Journal of Anaesthesia, 2002, Vol. 88, No. 4 597-599
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Oxygen embolism after hydrogen peroxide irrigation of a vulvar abscess

G. Haller*,1, E. Faltin-Traub2, D. Faltin2 and C. Kern1

1Division of Anaesthesiology, Department APSIC and 2Department of Obstetrics and Gynaecology, University Hospitals, CH-1211 Geneva 14, Switzerland*Corresponding author

We report a case of venous oxygen embolism in a 33-yr-old healthy woman after irrigation of a vulvar abscess with 25 ml of 3% hydrogen peroxide. Venous oxygen embolism was diagnosed by the development of sudden hypoxia associated with a decrease in end-tidal carbon dioxide concentration from 5.3 kPa to 3.2 kPa, and a ‘mill-wheel’ sound on cardiac auscultation soon after injection of the solution. The patient responded to corrective treatment including the Trendelenburg position and 100% oxygen. She made an uneventful recovery. We discuss the possible causative mechanism of this embolism, the different diagnostic methods, and the controversial aspects of available treatments. We emphasize that hydrogen peroxide is a dangerous and unsuitable agent for routine wound irrigation and debridement.

Br J Anaesth 2002; 88: 597–9


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